Preliminary evaluation of home-delivered meals for reducing frailty in older adults at risk for mal-nutrition

Objective: To examine the potential benefit of home-delivered meals for reducing frailty levels among community- dwelling older adults at risk for malnutrition. Design: A retrospective, single-group observational approach. Setting: One large home-delivered meal agency in the Midwest United States. Participants: 1090 community-dwelling older adults who received home-delivered meal services, funded through the Older Americans Act, between June 2020 and December 2021. Measurement: Frailty status was measured by the Home Care Frailty Scale (HCFS) which was routinely administered by agency staff to home-delivered meal clients as part of a quality improvement project. The HCFS was administered at the start of meal services, 3-months after meals began, and 6-months after meals began. Results: At baseline, 55.4% of clients were found to be at high risk for malnutrition. While there was a significant and consistent decline in HCFS throughout the follow-up period for both high and low nutritional risk groups, the reduction in frailty from baseline to 6-months was greater for the high nutritional risk group (Delta=-1.9; 95% CI: [-2.7,-1.1]; p <0.001) compared to those with low nutritional risk (Delta=-1.5; 95% CI: [-2.3,-0.7]; p < 0.001). Compared to those who lived alone, clients who lived with other individuals presented with higher levels of frailty at baseline and 3-month follow-up for both low and high malnutrition risk groups. Conclusion: Home-delivered meal clients are commonly at risk for both frailty and malnutrition. Home-delivered meal programs, which are intended to reduce malnutrition among older adults, may serve as a promising solution for reducing frailty in the vulnerable aging population.